CfH to crack down on C&B ‘misuse’

NHS Connecting for Heath is hoping to crack down on the misuse of Choose and Book through new guidance that will be published in the next few weeks.

The guidance, entitled Responsibilities and Operational Requirements for the Correct use for Choose and Book, seeks to underline how the e-booking system should be used by GP practices and hospital trusts.

Dr Stephen Miller, medical director of Choose and Book, told EHI Primary Care that he expected the guidance to “raise a few eyebrows in the NHS”.

He added: “There are lots of inappropriate uses of the system which is why some people are not seeing the benefits.”

Dr Miller said he did not want to elaborate in advance of the guidance being published, but hoped it would encourage local health communities to use the system as it was intended.

He said the guidance had been produced largely in response to requests from various bodies, including strategic health authorities, the BMA and groups of individual GP practices.

The last few years has seen hospitals accused of using the system to manage 18 week wait targets by limiting slot availability.

GPs have been criticised for delegating the entire process to administrative staff and primary care trusts have been criticised for using the system to manage referrals through referral management centres.

Dr Miller said current usage rates for booking first outpatient appointments remained around 54%, where they have been all year.

He added: “It seems to have plateaued in the mid-50s and we are looking at new ways of promoting the benefits of Choose and Book to try and reach groups of people who have never used it or used it in the early days and not come back.”

Dr Miller said Atos Origin, the supplier that designed, developed and now manages Choose and Book, had also done a benefits’ analysis that recommended a number of strategies that CfH is considering.

In the meantime, the agency is adopting a ‘targeted intervention approach’ to help trusts that are struggling with Choose and Book and that have asked CfH for help, Dr Miller revealed.

He said this involves going into communities for a short time and making recommendations about how issues can be tackled. These include reconciling Choose and Book with 18 week wait targets.

Dr Miller added: “The minimum we ask for is that there is chief executive buy-in that they will look at our recommendations and see how they could change the way they work.”

Dr Miller said it was early days on this approach but so far the response had been positive. Other initiatives include a series of clinical master classes in SHAs.

The IT agency is also highlighting a series of case studies showing where Choose and Book is working well. 

These include Pennine Acute Trust, which has been one of the highest performing trusts in England. It found the average time it took to respond to a referral fell from 25 days to just over five days when consultants started to review referrals online using Choose and Book.